Deck 24: Nutritional Care of the Terminally Ill

Question 1

Impairment or perversion of gustatory sense wherein normal tastes are perceived as unpleasant is:
1) Dysgeusia
2) Parotitis
3) Stomatitis
4) Xerostomia

Answer 1

1

Question 2

Discoloration (blue, gray, or purple) of the skin or mucous membranes due to lack of oxygen in the blood is called ______.
1) Petechiae
2) Contusions
3) Cyanosis
4) Purpura

Answer 2

3

Question 3

Which of the following roles is most important in the care of a terminally ill client?
1) Care provider
2) Client advocate
3) Counselor
4) Teacher

Answer 3

2

Question 4

Which of the following would be most appropriate to suggest to a client with hiccups?
1) Avoiding peppermint flavorings
2) Swallowing a teaspoonful of granulated sugar
3) Increasing the amount of fluid consumed at each meal
4) Using straws to ingest liquids and semisolids

Question 5

Which of the following would be least indicative of approaching death?
1) Cessation of eating
2) Cyanosis and dyspnea
3) Muscle weakness
4) Polyuria and incontinence

Question 6

Ms. D has been under the care of hospice for 4 months. For the past few days she has taken only one-fourth of her usual food. Her caregiver is greatly concerned. What advice would be least appropriate?
1) "Offer her tasty foods to show you love her."
2) "Be firm like a parent and insist that she increase her intake."
3) "See if she would take just an ounce of complete supplement every hour."
4) "Ask her what she wants from you. It may be just companionship."

Question 7

The goal of nutrition screening for the client under hospice care is which of the following?
1) Recognize areas for improvement in diet.
2) Identify food-related concerns.
3) Gather data to correlate long-term nutritional habits with the onset of disease.
4) Distinguish food-handling practices that are suboptimal.

Question 8

Dryness of the mouth caused by an abnormal reduction in salivary secretion is:
1) Dysgeusia
2) Parotitis
3) Stomatitis
4) Xerostomia

Question 9

In some states, a charge of ______ can be brought if a client is fed artificially against his or her wishes.
1) Assault
2) Battery
3) Malpractice
4) Negligence

Question 10

The goal of palliative nutritional care for the terminally ill client is to do which of the following?
1) Alleviate discomfort and relieve symptoms
2) Maximize intake of a balanced diet
3) Compensate for malabsorption problems
4) Substitute a liquid complete nutritional supplement for solid food

Question 11

Ms. N is a hospice client who has had insulin-dependent diabetes mellitus (type 1 diabetes) for many years. The visiting nurse asks the client and caregiver to relate the client's history of clinical signs and symptoms of hypoglycemia. The nurse is concerned because of which of the following reasons?
1) Often no signs and symptoms of impending coma are shown because of epinephrine deficiency.
2) With approaching death, hyperglycemia needs to be steadfastly avoided.
3) Ketoacidosis is particularly hazardous for the client with a terminal illness.
4) A change in type or dose of insulin may be required to counterbalance the client's hypersensitivity to the drug.

Question 12

A client is terminally ill when he or she has an irreversible lethal disease and death is expected within which time frame?
1) 2 months
2) 3 months
3) 6 months
4) 1 year

Question 13

Mr. W, a hospice client, wishes to treat his anemia so he will not feel so fatigued. Which of the following would be least appropriate to suggest?
1) Iron-fortified cereals
2) Citrus fruits with every meal
3) Chicken breasts every other day
4) Raisins and prunes for snacks

Question 14

An assessment question about fat in the diet of a terminally ill client is appropriate if the client has complained about:
1) Constipation
2) Dyspnea
3) Ravenous hunger
4) Steatorrhea

Question 15

Many foods taste bitter to a client. Which of the following suggestions would be expected to help alleviate this problem?
1) Adding cocoa to coffee for a mocha flavor
2) Marinating beef in vinegar sauce before cooking
3) Sprinkling coarse salt on the fish before baking
4) Using glass cooking utensils

Question 16

Ms. L has an abdominal cancer that is causing a partial bowel obstruction. She is able to take oral nourishment and has refused a feeding tube. Which of the following would be least appropriate to give?
1) Liquid supplement
2) Dietary fiber with every meal and feeding
3) Clear liquids
4) Lean, tender chicken or turkey

Question 17

Ms. L is actively dying and has refused oral intake. Her caregiver is concerned. Which of the following responses would be the most helpful to the caregiver?
1) "Offer her fluids every hour, but respect her right to refuse."
2) "Let's see if we can obtain an order for an antipyretic suppository."
3) "Dehydration is not painful and eases the passage from life. Offer sips of fluid upon request."
4) "Put some fluid into her mouth every half hour and see if she will swallow it."

Question 18

Ms. N is a hospice client who has had insulin-dependent diabetes mellitus (type 1 diabetes) for many years. The visiting nurse instructs the caregiver to feed Ms. N 30 to 50 g of carbohydrate every 3 hours:
1) To prevent starvation ketosis
2) To promote water excretion
3) To spare fat for weight gain
4) To show a sign of loving care and concern

Question 19

A client is complaining of pruritus. The nurse interprets this as which of the following?
1) Excessive hair growth above the lip
2) Severe itching
3) Hives
4) Inflammation of the skin

Question 20

Which of the following statements is true?
1) Nutrition support is medically optional except for comatose clients.
2) Hydration is medically mandatory as long as a client can swallow.
3) State laws vary as to the obligation to provide hydration and nutrition.
4) Federal statutes require both nutrition and hydration be provided as long as life persists.

Question 21

Which of the following would be considered a suitable range for blood glucose in the hospice population?
1) 60 to 100 mg/dL
2) 100 to 120 mg/dL
3) 127 to 309 mg/dL
4) 400 mg/dL and above

Question 22

Ms. O is a hospice client suffering from daily nausea and vomiting. Which of the following should be corrected to help alleviate the nausea and vomiting?
1) Remove the partially filled emesis basin next to her lunch tray.
2) Post a daily schedule showing exercise periods following breakfast, lunch, and dinner.
3) Provide a lunch tray containing foods from all the groups.
4) Restrict liquids to mealtimes.

Question 23

The nurse is working with a client experiencing migraine headaches. When discussing possible triggers, which of the following would the nurse be least likely to include?
1) Overeating
2) Food additives
3) Peanuts
4) Caffeine

Question 24

A client has dyspnea and has read that caffeine helps break up and expel secretions. The client asks you for a recommendation. An appropriate response would be which of the following?
1) Caffeine is a bronchodilator, so it is correct.
2) Consumption of caffeine is never recommended.
3) Milk will help prevent the mucus.
4) Fruit juice will work just as well.

Question 25

After teaching a group of nurses about the signs of approaching death, the instructor determines that additional teaching is needed when the group identifies which of the following as a sign?
1) Decrease in body temperature
2) Decreased verbalization
3) Increase in pulse rate
4) Fall in blood pressure